TY - JOUR
T1 - Joint swelling in the hand in rheumatoid arthritis
T2 - agreement between clinical evaluation, ultrasonography, magnetic resonance imaging and patient self-evaluation
AU - Brix, Lau
AU - Hedemann-Nielsen, Agnete
AU - Medrud, Lise
AU - Fredberg, Ulrich
AU - Ellingsen, Torkell
PY - 2025/1
Y1 - 2025/1
N2 - OBJECTIVE: To describe agreement in detection of joint swelling as the mandatory key of the diagnostic algorithm used in rheumatoid arthritis (RA). This was done by comparing clinical examinations, ultrasonography (US), Magnetic Resonance Imaging (MRI) and patient self-evaluation of the joints in the wrist and fingers (metacarpophalangeal joints (MCP) and proximal interphalangeal joints (PIP)) in an early untreated RA cohort.METHODS: 14 patients (8 women and 6 men, mean age ± standard deviation: 54.9 ± 14.5 years, range: 34-81 years) with symptom duration of less than six months, steroid and DMARD naïve at the time of examination and no previous history of arthritis were included in the study. US techniques included B mode and Color Doppler while MRI included a variety of imaging sequences (STIR, T1W TSE and T1W VIBE).RESULTS: Overall, there was good agreement between clinical evaluation, evaluation by US, by MRI or patients' own evaluation of joint swelling. Patient self-evaluation converged with the clinical evaluation in 12 cases (86%).CONCLUSION: Agreement was good among the applied imaging modalities and patient self-evaluation when compared to the clinical evaluations. Adding MRI to the US examination did not provide further diagnostic information.
AB - OBJECTIVE: To describe agreement in detection of joint swelling as the mandatory key of the diagnostic algorithm used in rheumatoid arthritis (RA). This was done by comparing clinical examinations, ultrasonography (US), Magnetic Resonance Imaging (MRI) and patient self-evaluation of the joints in the wrist and fingers (metacarpophalangeal joints (MCP) and proximal interphalangeal joints (PIP)) in an early untreated RA cohort.METHODS: 14 patients (8 women and 6 men, mean age ± standard deviation: 54.9 ± 14.5 years, range: 34-81 years) with symptom duration of less than six months, steroid and DMARD naïve at the time of examination and no previous history of arthritis were included in the study. US techniques included B mode and Color Doppler while MRI included a variety of imaging sequences (STIR, T1W TSE and T1W VIBE).RESULTS: Overall, there was good agreement between clinical evaluation, evaluation by US, by MRI or patients' own evaluation of joint swelling. Patient self-evaluation converged with the clinical evaluation in 12 cases (86%).CONCLUSION: Agreement was good among the applied imaging modalities and patient self-evaluation when compared to the clinical evaluations. Adding MRI to the US examination did not provide further diagnostic information.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Arthritis, Rheumatoid/diagnostic imaging
KW - Diagnostic Self Evaluation
KW - Edema/diagnostic imaging
KW - Female
KW - Finger Joint/diagnostic imaging
KW - Humans
KW - Magnetic Resonance Imaging
KW - Male
KW - Metacarpophalangeal Joint/diagnostic imaging
KW - Middle Aged
KW - Physical Examination
KW - Predictive Value of Tests
KW - Reproducibility of Results
KW - Ultrasonography
KW - Ultrasonography, Doppler, Color
KW - Wrist Joint/diagnostic imaging
UR - http://www.scopus.com/inward/record.url?scp=85212110802&partnerID=8YFLogxK
U2 - 10.1007/s00296-024-05762-7
DO - 10.1007/s00296-024-05762-7
M3 - Journal article
C2 - 39673616
SN - 0172-8172
VL - 45
JO - Rheumatology International
JF - Rheumatology International
IS - 1
M1 - 1
ER -